This is a retrospective clinical analysis of 122 patients with periampullary cancer(including cancer of the head of the pancreas, the ampulla of Vater, the part of the common bile duct, and the second part of the duodenum) treated at the
department
of
surgery, medical college of Korea University during the past 10 years. The 6th and 7th decades were the most common age groups, occupying 66% of the patients, with the average age of 56.8 years. Male to female ratio was 1.8:1. Approximately 50%
of
lesion located at the head of the pancreas. CT scan and ERCP were the principle modalities available for diagnosis, and recorded 82% and 84% of diagnostic accuracy, respectively. 65 cases(53.3%) were resected with curative intention.
Pancreatoduodenectomy was performed on 56 patients. Total and regional pancreatectomy were done on 7 and 2 patients, respectively. The resection rate for lesion of the head of the pancreas was 39%; for other periampullary tumors it was 68%.
Hospital
morbidity and mortality following pancreatoduodenectomy were 41% and 6.9%, respectively. Among 4 patients with operative mortaliy, 2 died with complication of pancreatic leakage and 2 with bleeding. TNM staging revealed 66% of the patients were
in
stage
III, 26% in stage I, and 8% in stage II. The actuarial 1, 3, and 5-year survival rates after resection were 68, 25, and 15%, respectively. In non-resected group, none survived at 18 months after treatment. We insist the only chance of survival
for
these
unfortunate patients is a surgical resection. And relatively high portion of positive lymph node involvement(66%) may explain the poor 5-year survival in this study. In fact, among patients with stage I, the actuarial 5-year survival rate was
36%.
Further investigation and effort will necessary to diagnose at a earlier stage and treat accordingly.
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